State Medicaid Waiver Programs Can Pay for a Lifetime of Needs

Question: How do state Medicaid waiver programs play a role in the planning for my son, especially with the long waiting list?

State Medicaid Waiver Programs Can Pay for a Lifetime of Needs

State Medicaid Waiver programs can play a significant role in providing care for your son’s lifetime need for support.  While many families can be discouraged by the waiting lists that exist in most states, these programs can end up providing over $100,000 worth of services on an annual basis.

For instance, in North Carolina, the waiver slots are capped at $135,000 per year, but the average waiver slot provides an annual service budget of $65,000. These dollars help individuals with intellectual and developmental disabilities (IDD), including those diagnosed with autism, live as independently as possible by providing daily support workers, housing, job support, transportation and more.  It is usually a long wait (could be 10 years or more), but these services last a lifetime [as long as no mistakes are made in your overall planning].

States are trying to determine how to offer these waiver services to more and more individuals because, with the increase in diagnosis, more individuals are applying for these services, but the funding is not unlimited.  One idea is to reduce the budget for those who have the waiver currently and reroute those dollars to new waiver slots.

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If that does occur, then those on the waiver will see their services reduced which very well may affect their ability to live independently. It is true that with the confluence of the fiscal issues in our federal and state governments, the increased diagnosis of those with IDD and autism, the increase in life expectancy, and the already long wait for waiver services, families will have to carry a higher level of financial responsibility for their child’s future support needs.

Although Government Benefits will most likely play a major role in the life of an individual with IDD, the families will have to plan appropriately (with the right tools) to keep those benefits flowing and will have to provide more of the resources than they have had to in the past.

The landscape is changing and certainly requires more careful planning than in the past, but these waiver services (and government benefits as a whole) are still services worth the wait. If you are not on the waiting list for these waiver services in your state, please contact your state’s division of  health and human services to find out the process.

For more information on how to prepare for the future, be sure to contact a financial advisor who specializes in serving families with special needs. A Special Needs Plan is driven by their purpose of leading families to independence through an on-going multi-generational plan. A Special Needs Plan is passionate about families confidently moving forward.

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Charlotte, NC 28204

This article was featured in Issue 88 – Knowledge is Power

Ryan Platt

Ryan F. Platt, MBA, ChFC, ChSNC, completed his Special Care Planner Certification in 2005 at the American College in Bryn Mawr, PA, in which he received advanced training in estate and tax planning, special needs trusts, government programs, and the emotional dynamics of working with people and families with special needs loved ones. In 2013, he went on to complete the Chartered Special Needs Consultant designation. A pioneer in his field, Ryan is one of only a few planners certified through Massachusetts Mutual Life Insurance Company (MassMutual) and the American College in Special Care Planning in Charlotte. He is the founder of A Special Needs Plan.